The invention relates to a modular surgical training system for training in surgical interventions using real surgical instruments.
Surgical interventions relate to the treatment, i.e., the therapy, of diseases and injuries by direct, manual or instrumental action on the body of the patient, wherein these surgical interventions are adequately referred to as operation or in short OPs. Operations are known both from human medicine and also from veterinary medicine.
For the purpose of practical learning, repeated practice, and for perfecting surgical techniques, a great variety of training systems are known, which differ considerably with regard to their claim to realistic simulation of the actual surgical environment. In addition to entirely computer-based virtual training systems such as those offered, for example, by the company Industrial Virtual Reality Inc., other training systems are known, in which the surgical intervention is practiced on a more or less detailed simulation of an anatomical structure.
These simulated anatomical structures are usually plastic models that can have greatly differing features in terms of their complexity and realistic simulation. In addition to solid bone structures, they contain mainly resilient materials for the representation of human tissue. To achieve the most realistic simulation possible, the focus is primarily on the haptic properties of the anatomical structure, in particular, of the different tissue types such as, for example, bones, vessels or nerves, during the interaction with the surgical instruments held by the practicing operator. During the training, the anatomical structure used is used-up by mechanical treatment such as, for example, cutting, milling or the like, so that it needs to be replaced before the next training session.
Systems for reproducing bodily functions such as, for example, a simulated cardiac circulation system with pulse, blood pressure but also other bodily fluids can be added to these simulated anatomical structures themselves. The simulation of these bodily functions increases the degree of detail of the haptic simulation for the person in training, for example, by simulation of the pressure of the cerebrospinal fluid. Moreover, it is known that bleeding, for example, is simulated by way of filled capsules that are caused to burst, or by way of devices for generating large amounts of blood, as occurs, for example, as a result of severed limbs or arterial injuries.
Furthermore, it is known to reproduce bodily fluids by media such as, for example, fake blood, in order to approximate the color, consistency and external appearance of actual blood as closely as possible. For the generation of a flow or a pressure increase of the corresponding bodily fluids, pumps, primarily peristaltic pumps, and/or valves as well as corresponding lines are used. The peristaltic pumps, also referred to as hose pumps, used here are associated with dead times in the conveyance, due primarily to the principle of operation. The media used for the training have to be refilled or replaced before the next training session. This harbors a number of different disadvantages. Thus, when refilling the media, sufficient venting of the conveyance system must always be ensured; in addition, after a reservoir container for these media has been used repeatedly, deposits and encrustations can occur, which in turn lead to sticking and/or clogging.
This results, therefore, in time consuming and expensive cleaning work.
In a real OP, in the general case, there is stress on sensitive tissues, the at-risk structures, that can cause postoperative complications in human patients. Typical stress types on at-risk structures such as nerves and vessels that occur during OPs are compression (squeezing, compressive stress) and traction (elongation, tensile stress). For the quantitative evaluation of the surgical interventions for training, it is therefore known to use sensors, in particular, pressure sensors and strain gauges. Since the sensors used are located directly on the anatomical structure, they too have to be exchanged before each new training session along with the anatomical structure, which again results in added costs.
There are known surgical training systems that combine individual aspects of the described aspects, such as the reproduction of an anatomical structure, the reproduction of various bodily fluids or the use of a sensor system.
Thus, US 2009/0246747 A1 discloses a training system that reproduces the inside of a human or animal body with all the important organs. The training system includes the reproduction of the cardiac circulation system, wherein the heart is reproduced by a peristaltic pump. The large vessels such as the aorta are reproduced by hoses, wherein the internal pressure of the hoses can be measured by means of pressure sensors, or the volume flow of the medium reproducing the blood can be measured by means of flow meters. Reproduced organs can have channels for the reproduction of the vessels of the organ. Thus, in one design, a vessel rupture of a kidney is reproduced, wherein the medium conveyed by the peristaltic pump exits the vessels in large amounts. If the structure of individual organs has been changed by the training session, for example, by the use of a scalpel, the entire organ is exchanged.
This training system has several disadvantages. After completion of a training session, for example, an operation on a kidney, large parts of the training system can be soiled by exiting fake blood, as a result of which these parts have to be subjected to a thorough time-consuming cleaning. In addition, the reservoir containers of the used-up media have to be refilled again. The used-up anatomical structures, possibly including the corresponding sensors, have to be replaced and connected again to the other organs or vessels. Overall, this involves a very high expenditure in terms of time and personnel, but in the end a very high financial expenditure. In addition, the training system is not available at that time.
Moreover, from WO 2009/067778 A1 a modular training system is known for practicing operations on and/or in the human skull. The training system is provided, for example, for operations for placing an external drain in order to lower the pressure within a ventricle filled with cerebrospinal fluid. For this purpose, the training system comprises a base module and a training module. The training module comprises the reproduced anatomical structure in the form of the ventricle, wherein the ventricle is formed as a latex balloon and filled with water. For the generation of a realistic ventricular internal pressure, the base module comprises a pressure generator, which is formed by a column of liquid. The hydrostatic pressure of the column of liquid acts on a second balloon which is arranged on the base module. If training module and base module are connected to one another, then the second balloon is in an operative connection with a latex balloon. Using a scale that is arranged on the column of liquid, the pressure exerted on the ventricle by the person in training can be quantitatively determined as well.
The disadvantage of this system is that the simulation of bleeding is completely dispensed with. In addition, due to the special design of the base station, the base station is suitable only for simulating operations on and/or in the skull. There is no provision for training on other anatomical structures, as a result of which the field of use is very limited. Furthermore, the pressure generator with the liquid located therein needs to be maintained regularly, since, for example, due to evaporation, liquid can escape, as a result of which the hydrostatic pressure of the column of liquid can vary from one training session to the other. As a result, a new calibration of the pressure generator is needed, which in turn is associated with a time and cost expenditure.
An object of the present invention therefore consists in providing a modular surgical training system which avoids the disadvantages of the prior art and which can be put into operation and returned to a state ready for use by a user within a short period of time without trained personnel and without the user in the process coming into contact with consumable liquids or other liquids, and which is low maintenance, does not require calibration by the user, and is flexible, i.e., suitable for training in a great variety of surgical interventions.